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Published on: January 28, 2020
Elevated cardiac biomarkers may be effective prognostic predictors for patients with COVID-19: A multicenter,
Jie Yang1, Xuelian Liao1, Wanhong Yin2
1Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, China.
Insights
Elevated cardiac biomarkers, creatine kinase isoenzyme (CK-MB) and myoglobin, effectively predict adverse outcomes in COVID-19 patients. Their combined use shows enhanced prognostic performance for in-hospital death and non-recovery.
Area of Science:
- Cardiology
- Infectious Diseases
- Biomarkers
Background:
- Coronavirus disease 2019 (COVID-19) is a global health crisis.
- Elevated cardiac biomarkers such as creatine kinase isoenzyme (CK-MB) and myoglobin are observed in COVID-19 patients.
Purpose of the Study:
- To investigate the prognostic value of elevated cardiac biomarkers in predicting adverse outcomes for COVID-19 patients.
- To assess if CK-MB and myoglobin can serve as effective predictors for in-hospital death and recovery status.
Main Methods:
- A cohort of 357 COVID-19 patients was analyzed.
- LASSO regression identified predictors for in-hospital death and 28-day recovery status.
- Receiver operating characteristic (ROC) curve analysis and area under the curve (AUC) evaluated prognostic values.
Main Results:
- Elevated CK-MB and myoglobin were identified as independent risk predictors for in-hospital death and non-recovery.
- AUC values for CK-MB and myoglobin individually ranged from 0.838 to 0.862 for death and 0.839 to 0.841 for non-recovery.
- Combined use of CK-MB and myoglobin demonstrated improved AUC values of 0.883 for in-hospital death and 0.873 for non-recovery.
Conclusions:
- Elevated CK-MB and myoglobin upon admission are effective predictors of adverse outcomes in COVID-19.
- The combined assessment of CK-MB and myoglobin offers superior predictive performance for adverse outcomes in COVID-19 patients.
Purpose:
The coronavirus disease 19 (COVID-19) has become a global health event. Cardiac biomarkers like creatine kinase isoenzyme (CK-MB), myoglobin, and high-sensitivity troponin T were usually elevated in early stages. This study aimed to investigate whether the elevated cardiac biomarkers could become effective prognostic predictors for COVID-19 patients.
Methods:
The present study involved 357 COVID-19 patients. The potential predictors for two study outcomes (in-hospital death and recovery status) in 28 days were selected by LASSO regression analysis. Prognostic values of cardiac biomarkers selected were evaluated using the receiver operating characteristic curve (ROC) and the area under ROC (AUC).
Results:
After 28-day follow-up, overall 357 patients were divided into death group (n = 25) and survival group (n = 332), or non-recovery group (n = 43) and recovery group (n = 314). The LASSO regression analysis showed elevated CK-MB and myoglobin were independent risk predictors for in-hospital death, and CK-MB and myoglobin were also independent risk predictors for non-recovery. The AUC of CK-MB and myoglobin for in-hospital death were 0.862 (95%CL: 0.804-0.920, p < 0.001) and 0.838 respectively (95%CL: 0.729-0.947, p < 0.001). The AUC of CK-MB and myoglobin for non-recovery were 0.839 (95%CL: 0.786-0.892, p < 0.001) and 0.841 (95%CL: 0.765-0.918, p < 0.001) respectively. We also found AUC of combined use of CK-MB and myoglobin for in-hospital death and non-recovery were 0.883 (95CL: 0.813-0.952, p < 0.001), and 0.873 (95%CL: 0.817-0.930, p < 0.001) respectively.
Conclusions:
In patients with COVID-19, elevated CK-MB and myoglobin on admission may be effective predictors for adverse outcomes, and combined use of CK-MB and myoglobin had a better performance for prediction.
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